Exploring perceptions and experiences with stigma among Danish women with gestational diabetes: a qualitative investigation

Background & aim: Being diagnosed with gestational diabetes mellitus (GDM) has been shown to affect women’s psychosocial health during and after pregnancy. These ramifications have been suggested to stem from stigma associated with GDM; however, no studies have systematically investigated GDM-specific stigma as experienced by women with GDM. Therefore, the aim of this study is to investigate the GDM-specific stigma as expressed amongst Danish women diagnosed with GDM. This abstract is based on preliminary data from the first six interviews. The final analysis and results will be available at the DPSG meeting.
Method: A qualitative study was conducted. Six women with GDM were interviewed (Final analysis will include ~25). All interviews will be transcribed verbatim and coded using a data-driven approach and analysed using Link and Phelan’s conceptualisation of stigma.
Results: Overall, the preliminary results indicate that the women perceived GDM to be a stigmatised diagnosis. The women preferred referring to GDM as “gestational/pregnancy diabetes”, as opposed to the lay term “gestational/pregnancy sugar disease” [in Danish]. Almost all women reported being aware of stereotypes associated with GDM, such as having inactive behaviour, poor eating habits, and living with overweight, which is also a stigmatised condition. None of the women reported experiencing prejudice from their family and friends. However, the women anticipated being met with more prejudice from others in general when using the term “sugar disease” as opposed to “diabetes”. Some women also did not want to disclose their diagnosis to people outside the immediate family, as they were ashamed of having GDM. The women were overall satisfied with the healthcare personnel providing care for them, as they felt empowered and recognized as individuals. Yet, the lifestyle recommendations were in some cases perceived as condescending and presumptuous. Women who did not need insulin therapy perceived their GDM as mild or borderline and articulated distancing themselves from other women with GDM.
Conclusions: The preliminary analysis from six interviews with women with GDM suggests that women with GDM perceived GDM to be a stigmatised diagnosis. Although the overall satisfaction with healthcare personnel was high, the women sometimes perceived health care advice to be condescending and presumptuous of their health behaviour. Not disclosing their diagnosis, feeling ashamed, and distancing themselves from having GDM indicates that the women had internalised the GDM-specific stigma. Interviewing more women with GDM from a variety of sociodemographic backgrounds will create further insights into the experienced stigma associated with GDM.